Visibility of Intracranial Perforating Arteries Using Ultra-High-Resolution Photon-Counting Detector Computed Tomography (CT) Angiography

Abstract

Background/Objectives: Photon-counting detector computed tomography (PCD-CT) offers energy-resolved CT data with enhanced resolution, reduced electronic noise, and improved tissue contrast. This study aimed to evaluate the visibility of intracranial perforating arteries on ultra-high-resolution (UHR) CT angiography (CTA) on PCD-CT. Methods: A retrospective analysis of intracranial UHR PCD-CTA was performed for 30 patients. The image quality from four UHR PCD-CTA reconstruction methods [kernel Hv40 and Hv72, with and without quantum iterative reconstruction (QIR)] was assessed for the lenticulostriate arteries (LSAs) and pontine arteries (PAs). A subjective evaluation included peripheral visibility, vessel sharpness, and image noise, while objective analysis focused on the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Results: Peripheral LSAs were well visualized across all reconstruction methods, with no significant differences between them. Vessel sharpness and image noise varied significantly (p p p Conclusions: UHR PCD-CTA provided a good visualization of the intracranial perforating arteries, particularly LSAs. The vessel sharpness and image noise varied by reconstruction method, in which kernel Hv72 with QIR offered the optimal visualization.

Keywords

• photon-counting detector CT
• intracranial perforating arteries
• CT angiography
• ultra-high-resolution CT